Individual provider Active NPI

Stephen Mark Renzin, MD

  • Gynecology Physician
  • Larchmont, NY
National Provider Identifier
1316029671
Registry record updated Jul 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
117223 Issued in NY
Practice address
1 Madison Ave
FL 2
Larchmont, NY 10538-1929
Phone
(914) 833-1000
Fax
(914) 833-4226
NPI assigned
Oct 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 117223 NY Primary

Addresses

Primary practice location

1 Madison Ave
FL 2
Larchmont, NY 10538-1929

Mailing address

2071 Boston Post Rd
Larchmont, NY 10538-3701
Phone (914) 833-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051212000443 NY Practitioner - Obstetrics/Gynecology 0749201382 Practice locations: Larchmont, NY

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Wayne State University School of Medicine, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1 Madison Ave
Suite 2
Larchmont, NY 10538-1929
Phone (914) 833-1000

1 Madison Ave
Suite 2
Larchmont, NY 10538-3701

Hospital & facility affiliations

  • White Plains Hospital Center Hospital, White Plains, NY, CCN 330304

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
117223NYMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Docs Physicians Affiliated With Bimc Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500854400000",
    "number": "1316029671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2071 BOSTON POST RD",
            "city": "LARCHMONT",
            "state": "NY",
            "postal_code": "105383701",
            "telephone_number": "914-833-1000",
            "fax_number": "914-833-4226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MADISON AVE",
            "address_2": "FL 2",
            "city": "LARCHMONT",
            "state": "NY",
            "postal_code": "105381929",
            "telephone_number": "914-833-1000",
            "fax_number": "914-833-4226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENZIN",
        "first_name": "STEPHEN",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2017-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NY",
            "license": "117223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Larchmont, NY

Sources for this page

Verify at the official NPI Registry.